Table 1

Overview of systematic reviews of school-based PA or lifestyle interventions to increase PA or fitness in children and adolescents

DobbinsDe Meester/CrutzenSalmonvan SluijsCurrent review
Time searchedTo June 2007From January 1995 to May 2008From January 1985 to June 2006To December 2006From January 2007 to December 2010
Databases searchedMedline, Biosis, Cinahl, Embase, Sportdiscus, Psycinfo, Sociological abstracts, CentralPubmed, Medline, Web of Science, Sport Discus, Cochrane libraryMedline, Biosis, Cinahl, Embase, Sportdiscus, Psycinfo, PsycARTICLES, Cochrane, Central, ScienceDirect, Web of Knowledge, Social SciSearch, Ovid DatabasesMedline, Embase, Sportdiscus, Psycinfo, Pubmed, ScopusMedline, Embase, Sportdiscus, Psycinfo, Pubmed, Scopus
Inclusion criteriaPrimarily school-based interventions that promote PA and/or fitnessAll interventions that promote PA among European teenagersAll interventions that promote PAAll interventions that promote PAPrimarily school-based interventions to promote PA and/or fitness
CT or RCT with PA/fitness measured at baseline and postintervention
SettingSchool, school and/or family and/or communitySchool, family, community, primary care, internetSchool, family, community, internet-based, primary careSchool, family, communitySchool, school and family or community
Quality controlCochrane recommendations, ie, external validity, study design, confounders, blinding, reliability/validity of measurement tool, dropoutsNo quality controlBased on predominantly internal validity, including baseline comparability, randomisation, unit of analyses, validated outcome measure, dropout, timing of measurement, follow-up measure, intention-to-treat analysis, blinding, confounding
Exclusion criteriaLow qualityIf only fitness or PA during PE reportedSample size (n<16), if only fitness measuredNoneLow quality, duration <3 months
Selected studiesn=26n=20n=76n=57n=20
 In children/in adolescents/in both22/4/00/20/042/25/933/24/015/4/1
 In school settingAll (100%)15/20 (75%)57/76 (75%)47/57 (82%)All (100%)
Age (years)6–1810–194–19≤186–18
Countries (USA+Canada/Europe/Other)16/8/20/20/059/14/337/17/36/12/3
Overall results (with special focus on studies including the school system)Positive impact on duration of PA in school (5/7 studies effective) and fitness (3/5 studies significant)
No effect on LTPA outside school (3/7 studies significant)
Only 3/26 studies with PA outcome included adolescents
PA mostly assessed by questionnaires, transfer from PA in school to LTPA or overall PA not assessed
Lack of long-term effects
2/3 of studies showed positive effects on short-term improvements in PA, but in 3/20 studies with follow-up PA improvements not sustained
PA improvements mostly during school with no conclusive transfer to LTPA
Interventions more effective in the school than in other settings.
Most studies did not assess overall PA.
Studies that assessed PA objectively more effective than when PA assessed by questionnaires.
In half of the studies significant effect of the interventions on PA, about half children and adolescent studies.
Interventions in adolescents more effective than in children.
Target on migrants, those with low SES or girls only not effective.
Purely educational interventions not effective.
All studies showed a positive effect on one aspect of PA with 9/10 studies also documenting a positive effect on overall PA.
2/3 of studies showed increased fitness.
The majority of studies measured LTPA and/or overall PA, 60% by objective means.
Only 3 follow-ups, but all showing maintained effects in at least one PA domain.
Intervention success factorsInvolvement of specialists (for LTPA) and longer duration of the intervention (for PA in school) associated with positive intervention effectsMulticomponent programmes and those focusing only on PA rather than on multiple health behaviours, more effective
Family involvement inconclusive
In children: effective studies included a focus on PE, activity breaks or involvement of the family and were multicomponent
In adolescents: unclear
Interventions only focusing on curriculum change much less effective than multicomponent interventions
In children: no conclusion what type of intervention works best.
In adolescents: multicomponent interventions and those involving families or community most effective
In children: multicomponent interventions with family involvement most effective
In adolescents: inconclusive
Significant effect on PA8/14 (57%)13/20 (65%)PA: 38/76 (50%)27/57 (47%)16/16(100%)
Significant effect on fitness3/5 (60%)NANANA6/11 (55%)
Significant effect on motor skillsNANANANA4/6 (67%)
  • CT, controlled trial; LTPA, leisure time physical activity (PA outside school); NA, not applicable; PA, physical activity; PE, physical education; RCT, randomised controlled trial; SES, socioeconomic status.